Healthy Blue Refund Form

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Overpayment Refund Notification Form - Healthy Blue Ne

(4 days ago) WebOther health insurance/third-party liability Other: All refund checks should be mailed with a copy of this form to: Healthy Blue P.O. Box 933657 Atlanta, GA 31193-3657 Once the …

https://provider.healthybluene.com/docs/gpp/NE_CAID_RNF.pdf?v=202101052213

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Overpayment Refund Notification Form - Healthy Blue Louisiana

(7 days ago) WebHealthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield Association. BLAPEC-0644-17 …

https://provider.healthybluela.com/dam/publicdocuments/LALA_RefundNoticeForm_2.pdf?v=202101122212

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Overpayment Refund Notification Form - Healthy …

(1 days ago) WebAll refund checks should be mailed with a copy of this form to: Healthy Blue P.O. Box 933657 Atlanta, GA 31193-3657 Once the Healthy Blue Cost Containment Unit has …

https://provider.healthybluemo.com/docs/gpp/MO_CAID_RNFandRecoupmentForm.pdf?v=202101121822

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Overpayment Refund Form

(1 days ago) WebMail this form with check and remit to: Healthy Blue . Refunds Department (AX-480) P. O. Box 100317 . Columbia, SC 29202-3317 . Healthy Blue is offered by BlueChoice …

https://www.healthybluesc.com/sites/default/files/Overpayment%20Refund%20Form.pdf

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Overpayment Refund Notification Form - Blue Cross NC

(3 days ago) WebPlease note, this form applies to Healthy Blue + MedicareSM (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC). In order for an …

https://www.bluecrossnc.com/content/dam/bcbsnc/pdf/providers/network-programs/blue-medicare/forms/pre-service/dsnp-overpayment-refund-notification-form-bnccare.pdf

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Refunds Process Healthy Blue of South Carolina

(2 days ago) WebPlease include a copy of the refund request letter for accurate and timely processing. You can send a check and a copy of the letter to us by mail to the following address: Healthy …

https://www.healthybluesc.com/providers/claims/refunds-process

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Forms Healthy Blue

(8 days ago) WebHere, you will find a library of the forms most frequently used by health care professionals. Looking for a form but don’t see it here? Please contact your provider representative for …

https://provider.healthybluemo.com/missouri-provider/resources/forms

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Healthy Blue + Medicare HMO D-SNP Providers Blue Cross NC

(1 days ago) WebPhone: 866-611-4287. Fax: 855-443-7821. Healthy Blue + Medicare. 3350 Peachtree Road NE. Atlanta, GA 30326. View our Healthy Blue + Medicare D-SNP resources for the …

https://www.bluecrossnc.com/providers/networks-programs/blue-medicare/healthy-blue-medicare

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Provider Authorization to Adjust Claims and Create Claim …

(5 days ago) WebReturn this form via: Fax: 1-866-920-1874 Mail: Healthy Blue Attn: Cost Containment — Disputes P.O. Box 62427 Virginia Beach, VA 23466-2437 Note: Do not use this form if …

https://provider.healthybluenc.com/docs/gpp/BNCPEC-0151-21_Recoupment_Form-NC_fillable.pdf?v=202106031635

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Overpayment Refund Notification Form - Anthem Provider

(5 days ago) WebAnthem Blue Cross and Blue Shield P.O. Box 933657, Atlanta, GA 31192-3657. Once the Cost Containment Unit has reviewed the overpayment, you will receive a letter explaining …

https://providers.anthem.com/docs/gpp/IN_CAID_RefundForm.pdf?v=202106041458

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Manual and Forms Healthy Blue of South Carolina

(6 days ago) WebMenu. Manual and Forms. Image. Provider Office Manual. The provider office manual offers key administrative information, including the quality improvement program, utilization …

https://www.healthybluesc.com/providers/resources/manual-and-forms

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Recoupment Request form - Healthy Blue MO

(5 days ago) WebReturn this form via: Mail: Healthy Blue Attn: Cost Containment — Disputes P.O. Box 62427 Virginia Beach, VA 23466-2437 Fax: 1-866-920-1874 Note: Do not use this form …

https://provider.healthybluemo.com/docs/gpp/MO_CAID_RecoupmentForm.pdf?v=202202072109

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Employee Pharmacy Change Notice

(9 days ago) WebRefund Form . Use this form when sending Healthy Blue unsolicited/voluntary refund checks. To ensure proper routing of refunds, please complete this form and attach the …

https://www.healthybluesc.com/sites/default/files/PDFs/Forms/Blue%20Choice%20overpayment_refund%20091923%20fillable.pdf

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Provider Authorization to Adjust Claims and Create Claim …

(1 days ago) WebReturn this form via: Mail: Healthy Blue . Attn: Cost Containment — Disputes . P.O. Box 62427 . Virginia Beach, VA 23466- 2437 . Fax: 1-866-920-1874. Note: Do not use this …

https://provider.healthybluene.com/docs/gpp/NE_CAID_Recoupment.pdf?v=202101052212

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Overpayment refund notification form - Empire Blue

(6 days ago) WebAll refund checks should be mailed with a copy of this form to: Empire BlueCross BlueShield HealthPlus P.O. Box 933657 Atlanta, GA 31193-3657 Once the Empire …

https://mediprovider.empireblue.com/docs/gpp/NYE_CAID_OverpaymentRefundNotificationForm.pdf?v=202102092335

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Provider Authorization to Adjust Claims and Create Claim …

(8 days ago) WebReturn this form via: Attn: Cost Containment — Disputes Healthy Blue P.O. Box 62427 Virginia Beach, VA 23466-2437 Fax: 1-866-920-1874 Note: Do not use this form if you …

https://provider.healthybluela.com/docs/gpp/LA_CAID_OverpaymentRecoupNoticeForm.pdf?v=202106032030

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Overpayment Refund Notification Form - Healthy Blue Louisiana

(4 days ago) WebHealthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield Association. BLACARE-0064 …

https://provider.healthybluela.com/docs/gpp/LA_CAID_OverpaymentRefundNotificationForm.pdf?v=202105141609

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2019-11 Overpayment Notification Form - Blue Cross and …

(6 days ago) Web18NW1463 R12/19 Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health …

https://providers.bcbsla.com/-/media/Files/Providers/ITS_RefundNotificationNAD18NW1463%20pdf.pdf

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Payments and Remittances Healthy Blue of South Carolina

(1 days ago) WebReturn the completed form to [email protected]. Go paperless! With electronic funds transfer (EFT) and electronic remittance advice (ERA), you can eliminate the …

https://www.healthybluesc.com/providers/claims/payments-and-remittances

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Overpayment Refund/Notification Form - UHCprovider.com

(2 days ago) WebRev. Jan 2019. This spreadsheet should be used to submit multiple refunds on an overpayment request from UnitedHealthcare. Please copy and paste this form to …

https://www.uhcprovider.com/content/dam/provider/docs/public/claims/Claims-Overpayment-Refund-Form.pdf

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